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The Diagnostic Value of Fe3+ and Inflammation Indicators in the Death of Sepsis Patients: A Retrospective Study of 428 Patients

Authors Wang J, Wang J, Wei B

Received 12 November 2020

Accepted for publication 21 December 2020

Published 15 January 2021 Volume 2021:17 Pages 55—63

DOI https://doi.org/10.2147/TCRM.S291242

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Deyun Wang


Jia Wang, Junyu Wang, Bing Wei

Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Capital Medical University, Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China

Correspondence: Bing Wei; Junyu Wang
Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Capital Medical University, Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, No. 5 Jingyuan Road, Shijingshan, Beijing 100043, People’s Republic of China
Tel +86-10-51718602
Email 13810051210@163.com; wangjunyu1007@163.com

Background: Studies have shown that a variety of blood inflammatory markers can be used to assess the criticality of patients with sepsis. In this study, the blood inflammatory factors related to the sepsis survival group and the death group were compared and analyzed, which can be used by clinicians to adjust sepsis patient treatment.
Methods: This study used retrospective methods to analyze the medical records of 428 patients with sepsis. The test of blood samples includes the patient’s age, gender, hospital stays, the concentration of procalcitonin (PCT), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), D-dimer (DD), Fe3+, and hemoglobin (Hb) in the venous blood of patients with sepsis. The detection of PCT methods adopts the sandwich immunofluorescence (IF). ROC curve was used for the diagnosis and analysis of various factors of sepsis.
Results: Among all the patients with sepsis, 133 patients died, with a mortality rate of 31.07%. Analysis of related inflammatory indicators and the patient’s baseline parameters showed the patients age, the values of PCT, ANC, NLR, and DD in death group were statistically higher than those in survival group (all p values were < 0.05). However, the concentration of Fe3+ and ALC show an opposite trend between the two groups. Regression analysis results showed the patient’s gender, Fe3+, PCT, ANC, and DD are all independent prognostic factors for patients with sepsis. The results of the ROC curve of related diagnostic indicators show that DD has the best area under curve (AUC=0.700), the most sensitive index is ANC (74.44), and the most specific index is PCT (89.80). The results of the two-by-two combined diagnosis of the four indicators showed that the PCT+DD group had better AUC (0.748) and specificity (78.23), and the Fe3++DD group had the best sensitivity (75.89).
Conclusion: In this study, the patient’s gender and the inflammation-related markers of Fe3+, PCT, ANC, and DD can be used as independent risk factors affecting the prognosis of patients with sepsis. The combination of PCT+DD and Fe3++DD has high diagnostic value for patients with sepsis.

Keywords: sepsis, procalcitonin, Fe3+, D-dimer, immunocyte, diagnosis

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